世界卫生组织、美国与欧盟复方口服避孕药使用标准和指南介绍及启示

发布时间：2018-08-31 09:43

【摘要】：目的:为修订和完善我国复方口服避孕药(COCs)的使用标准和指南提供参考。方法:对世界卫生组织(WHO)、美国与欧盟的COCs使用标准和指南进行介绍和比较。结果与结论:WHO曾先后制定了《避孕方法选用的医学标准》(MEC)、《避孕方法使用的选择性实用建议》(SPR)、《避孕节育知情选择咨询指南》和《计划生育服务提供者手册》等4部关于COCs的使用标准和指南。其中,MEC按照使用者的具体情况进行了适用、慎用、相对禁忌证、绝对禁忌证等分级;SPR主要介绍了如何安全、有效地使用各种避孕方法的具体内容;《避孕节育知情选择咨询指南》使用导读卡的模式,可快速查询避孕节育临床知情选择中的具体方法和步骤;《计划生育服务提供者手册》可为在一线工作的计划生育服务提供者进行实际的工作指导。美国在WHO MEC和WHO SPR的基础上,对个别项目进行了修改和补充,包括对母乳喂养者、COCs对复发深静脉血栓/肺栓塞风险的分级等。欧盟则早于WHO及美国制定了COCs的使用标准和指南,并不断根据最新的循证医学证据对COCs的关键风险点和特定品种进行了提示和更新,包括重新评估使用COCs后的血栓栓塞风险和对达英35#174;及其仿制药的特别安全提示等。我国应基于WHO、美国与欧盟的COCs使用的最佳证据,结合国情,为广大使用者和医护人员提供最新的、明确的COCs使用标准和指南。
[Abstract]:Objective: to provide a reference for the revision and improvement of the standards and guidelines for the use of Chinese compound contraceptive (COCs). Methods: the COCs standards and guidelines of WHO (WHO), USA and EU were introduced and compared. Results and conclusion: who has worked out four parts of "the Medical Standard of contraceptive method selection", "(MEC)," selective practical advice on contraceptive method use "," (SPR), "Counseling Guide to informed Choice of contraception" and "Manual of Family Planning Service providers", respectively. Standards and guidelines for the use of COCs. According to the specific situation of the user, the MEC is used carefully, the relative contraindication, the absolute contraindication and so on are classified as SPR, which mainly introduces how to be safe. Effective use of the specific content of various contraceptive methods; the guide to informed choice of contraception; the model for the use of reading cards, The detailed methods and steps in the clinical informed choice of contraception and birth control can be quickly queried, and the Manual of Family Planning Service providers can provide practical guidance for family planning service providers working in the front line. On the basis of WHO MEC and WHO SPR, individual projects have been modified and supplemented in the United States, including the classification of recurrent deep venous thrombosis / pulmonary embolism risk in breast-feeding patients. The European Union developed standards and guidelines for the use of COCs earlier than WHO and the United States, and constantly prompted and updated key risk points and specific types of COCs based on the latest evidence-based medical evidence. These include reassessment of thromboembolic risk after COCs use and special safety tips for Dafin 35 #174 and its generic drugs. Based on the best evidence of the use of COCs in the United States and the European Union, our country should provide the most up-to-date and clear standards and guidelines for the use of COCs for the vast number of users and medical personnel in combination with the national conditions.
【作者单位】：江苏省计划生育科学技术研究所;
【基金】：中央财政专项江苏省人口和计划生育委员会科技项目(No.JSFPC2014011)
【分类号】：R979.21

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